DESCRIPTION (Taken from the applicant's abstract): Dr. Lindsey Ann Criswell has demonstrated a strong commitment to patient-oriented research since the beginning of her rheumatology fellowship training at the University of California, San Francisco (UCSF). Dr. Criswell's track record in peer-reviewed publications and her ability to successfully compete for NIH and other sources of research funding provide compelling evidence of her ability to conduct high quality patient-oriented research. Furthermore, Dr. Criswell has successfully mentored a large number of junior clinical investigators who are now establishing their own independent patient-oriented research programs. During the past six years, Dr. Criswell's research program has focused on the genetic epidemiology of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). This work has led to several important findings, including the association of tumor necrosis factor polymorphism with RA severity through an interaction with the HLA-DRB 1 shared epitope. Due to the rapid pace of advances in analytic methods for genetically complex diseases such as RA and SLE, Dr. Criswell must continue to devote a substantial amount of time and effort to mastering these rapidly evolving methods. The K24 award offers a unique opportunity to provide support for this essential ongoing training. Dr. Criswell's immediate research goals are to successfully complete the research that is now funded and underway within her research unit. This application describes 3 projects that utilize state of the art methods to identify genetic and non-genetic risk factors for these complex diseases. The expertise of the study investigators in the areas of rheumatology, genetics and statistics, in conjunction with the progress of these studies to date, ensures a high likelihood of success for this work. The research environment at UCSF provides an outstanding environment in which Dr. Criswell can continue to develop as a leader in patient-oriented clinical research and as a mentor to junior clinical investigators. As a result of Dr. Criswell's role as the Associate Director of the UCSF General Clinical Research Center (GCRC), she is ideally positioned to make a major impact at UCSF as a mentor for young clinical investigators. Dr. Criswell has precisely the skills and career goals for which this program was developed, and the resources of the K24 award would greatly enhance Dr. Criswell's ability to accomplish her goals as a patient-oriented clinical researcher and mentor through the provision of essential resources and relief of patient care and other activities.